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General NPI Number Information
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NPI Number | 1972189868
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Entity Type | Individual
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Provider Name | GREGORY KIETH HINES JR. MSW, LSW
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Gender | Male
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Dates
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Enumeration Date | 03/22/2021
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Last Update Date | 08/15/2022
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Provider Practice Location Address
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Address Line | 431 E LIVINGSTON AVE
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City | COLUMBUS
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State | OH
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Zip | 43215-5533
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Country | US
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Telephone | 614-487-8758
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Fax |
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Provider Business Mailing Address
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Address Line | 5900 SHARON WOODS BLVD
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City | COLUMBUS
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State | OH
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Zip | 43229-2600
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Country | US
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Telephone | 614-895-6818
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.2101769-TRNE
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.2208031
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License Number State | OH
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